Cardiometabolic changes after continuous positive airway pressure for obstructive sleep apnoea: a randomised sham-controlled study

Thorax
Camilla M HoyosPeter Y Liu

Abstract

Impaired insulin sensitivity (ISx), increased visceral abdominal fat (VAF) and liver fat are all central components of the metabolic syndrome and characteristics of men with obstructive sleep apnoea (OSA). The reversibility of these observed changes with continuous positive airway pressure (CPAP) treatment in men with OSA has not been systematically studied in a randomised sham-controlled fashion. 65 men without diabetes who were CPAP naïve and had moderate to severe OSA (age=49±12 years, apnoea hypopnoea index (AHI)=39.9±17.7 events/h, body mass index=31.3±5.2 kg/m(2)) were randomised to receive either real (n=34) or sham (n=31) CPAP for 12 weeks. At 12 weeks, all subjects received real CPAP for an additional 12 weeks. Main outcomes were the change at week 12 from baseline in VAF, ISx and liver fat. Other metabolic outcomes were changes in the disposition index, total fat, and blood leptin and adiponectin concentrations. The AHI was lower on CPAP compared with sham by 33 events/h (95% CI-43.9 to -22.2, p<0.0001) after 12 weeks. There were no between-group differences at 12 weeks in VAF (-13.0 cm(3), -42.4 to 16.2, p=0.37), ISx (-0.13 (min(-1))(μU/ml))(-1), -0.40 to 0.14, p=0.33), liver fat (-0.5 cm(3), -3.8 to 2.7, p=0.74) or ...Continue Reading

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